ABSTRACT
A questionnaire survey was conducted to investigate the use of goreisan for headaches caused by weather and atmospheric pressure changes, and to clarify issues in promoting treatment with goreisan. The subjects were men and women in their 20s to 40s who developed headaches due to changes in weather and atmospheric pressure. Medication was used by 58.0% of the migraine group and 42.5% of the other headaches group. Among them, 27.5% of the migraine group and 15.1% of the other headaches group had used goreisan. Regarding the method of use of goreisan, the most common answer for the migraine group was “used after feeling a sign that headache is likely to occur,” whereas for the other headaches group, the most common response was “used after headache has occurred.” In the migraine group, the most frequent premonitory symptom was “stiffness in the shoulders and neck.” More than 80% of both groups were satisfied with the use of goreisan. In addition, 77.8% of migraine group and 59.5% of the other headaches group of those who had never used goreisan answered that they would like to use goreisan for headaches caused by weather or atmospheric pressure changes in the future. As a reason for not wanting to use goreisan, over half of both groups answered that they did not like the taste of herbal medicines. It is necessary to offer tablets to patients that do not like the taste.
ABSTRACT
We report a case of severe headache associated with cerebellar infarction was successfully treated with Kampo therapy. The patient complained of severe headache and vertigo in spite of standard therapy after the decompression craniectomy. However, his symptoms were relieved immediately by administration of goreisan. The pharmacological effect of Kampo formulation i.e. goreisan is still unknown, but this formulation has been used for headache with edema, vertigo and vomiting. According to the classic textbook, this formulation has a potential to improve water imbalance in the body, including brain edema. This Kampo medicine is seemed to be an alternative to manage such patients.
ABSTRACT
Painful orthopedic diseases are sometimes aggravated because of weather changes ; this is referred to as meteorological pain. We report two cases of great occipital neuralgia (GON) due to traffic accident in patients whose pain was aggravated by weather changes. Case 1 involved a 41-year-old woman who developed lumbago and cervical pain following a traffic accident. Two months after the accident, she had irregular occipital pain. Three months after the accident, a great typhoon occurred, and she suffered from severe occipital pain since that morning. She was diagnosed with GON as meteorological pain and was administered goreisan ; her occipital pain then improved. Case 2 involved a 31-year-old woman who developed cervical pain following a traffic accident. Three months after the accident, she experienced severe occipital pain due to weather changes. She was diagnosed with GON as meteorological pain and was administered goreisan ; her occipital pain then improved. Goreisan is dramatically effective for GON as meteorological pain caused by cervical sprain.
ABSTRACT
We report a case in which goreisan with hoketsuzai (blood-tonifying formula) was successful in the treatment of a marked nutritional disorder. A 17-year-old woman was screened for prominent emaciation of unknown cause. After the administration of goreisan, edema was reduced and her body weight increased. Subsequently, anemia improved and muscle mass increased with a combination of shimotsuto or sokeikakketsuto. It is possible that goreisan with hoketsuzai improved the water balance of the whole body including the digestive tract, and restored the digestive and absorptive function.
ABSTRACT
Although evidence of Western therapy for heart failure has been established, evidence of treatment for heart failure with chronic kidney disease (CKD) has still not been established. The efficacy of additional Oriental medicine to standard therapy for heart failure with CKD is unclear. To address this issue, we retrospectively evaluated 20 consecutive heart failure patients with CKD (≧stage 3) who were orally administered goreisan (7.5 g/day) due to insufficient efficacy of standard therapy in our hospital from November 2015 to December 2017. We assessed symptoms, chest X-ray, BNP concentration, serum electrolytes, eGRF, plasma osmolality, and side effects. Goreisan improved heart failure in 11 of 20 patients, did not significantly deteriorate renal function, plasma osmolality, and did not clinically affect electrolytes. In conclusion, the present study suggested that additional use of goreisan to Western standard therapy is safe and useful for heart failure with CKD.
ABSTRACT
The number of elderly people with chronic heart failure is increasing ; they have acute exacerbations at a high rate due to mergers of infections and others. At that time, they received furosemide intravenous injection and tolvaptan oral medication as internal treatments. However, there are refractory patients (tolvaptan nonresponder) at a certain frequency. In these cases we experienced two cases in which goreisan were effective for untreatable congestive heart failure. Goreisan administration resulted in an increase in urine volume in both cases, marked improvements in symptoms, physiological findings and various laboratory findings. In addition, they continued taking these medicines after discharge. As a result, for about a year, they were never rehospitalized due to heart failure. It is conceivable that goreisan normalized the uneven distribution of water in organs and tissues, and reactivated the action of tolvaptan in the renal collecting duct. These results suggest that the combined use of goreisan will be useful for untreatable congestive heart failure.
ABSTRACT
<p><b>Background </b>: Menstrual migraine is more resistant to treatment than that of nonmenstrual episodes. Hormonal progesterone changes may cause <i>sui </i>(water/fluid) disturbance, in Kampo medicine terms. We therefore treated patients with menstrual migraine in which goshuyuto was ineffective, with the combination of goreisan and goshuyuto.<br><b>Subjects & Methods </b>: Subjects were 37 female patients with coldness (mean age 37 years, age range 23-48 years), whose migraine during their intra-menstrual periods was successfully treated with goshuyuto for 3 months. In order to treat migraine in the menstrual period, goreisan was added to goshuyuto from 1 week before onset, until the end of their menstrual period. <b>Results </b>: Among 37 patients, the treatment was effective in 26 patients (70%). Significant variables were found to be dull headache (p = 0.003), edema (p = 0.006), vertigo (p = 0.014) and oliguria (p = 0.014) during attacks, as well as worsening before rain (p = 0.004). <b>Conclusion </b>: The periodical combination of goreisan and goshuyuto seems to be effective in patients with menstrual migraine who report symptoms of <i>sui </i>disturbance, such as dull headache and oliguria during their attacks.</p>
ABSTRACT
We report on a case of ascites with liver cirrhosis due to hepatitis B virus (HBV) that was successfully treated with a combination of inchinkoto and goreisan (inchinkoto-go-goreisan). Our patient, a 58-year-old woman had neglected her chronic B hepatitis and diabetes mellitus, and had not been treated with medication. She was admitted to our hospital because of severe jaundice and the ascites, which were noted when she consulted us for traumatic neck pain. Though we administered human albumin with diuretics, e.g. the combination of furosemide and spironolactone, the ascites did not improve. After administering a combination of inchinkoto and goreisan decoction, however, the ascites decreased rapidly within a month. In this case, we found that an inchinkoto-go-goreisan decoction was more effective than an inchinkoto decoction or a goreisan extract. This suggests that the effects of Gardenia and Rheum they are made from can be significant.
ABSTRACT
Introduction: Double dose of Goreisan was effective in a case of blepharophimosis due to facial edema caused by malignancy-related superior vena cava syndrome. Case: A 60-year old male patient diagnosed with squamous cell carcinoma of the tongue underwent brachytherapy, surgery, and several types of chemotherapy before cervical lymph node metastases developed. Cyberknife therapy was performed to reduce the volume of lymph node metastases, only to develop abscess and cause malignancy-related superior vena cava syndrome, leading to facial edema accompanied by blepharophimosis. Intravenous furosemide was not effective, so double dose of Goreisan, a traditional Chinese prescription was applied and the edema and blepharophimosis subsided immediately, thus enhanced the patient’s quality of life. Conclusion: Goreisan can be an effective option for cases of malignancy-related superior vena cava syndrome refractory to chemotherapy and/or radiotherapy.
ABSTRACT
We report a case of a 74-year-old male with hyponatremia complicated with small cell lung cancer. His hyponatremia worsened even with water restriction. Oral administration of sodium was difficult because of nausea and vomiting. We recognized this patient as having illness caused by excessive water accumulation within the body, and so prescribed goreisan 7.5 g/day to treat his hyponatremia. His hyponatremia improved after the administration of goreisan. Later his hyponatremia deteriorated while being administered of meloxicam, a cyclooxygenase-2 inhibitor. This case suggests that goreisan might inhibit water reabsorption by antidiuretic hormone at the collecting duct of the kidneys via stimulation of prostaglandin synthesis.
ABSTRACT
Enterovaginal fistula, which causes uncontrollable symptoms such as gas release, vaginal defecation, perineal erosion, and vaginitis, markedly reduces patients' quality of life. In this report, we present a case of successful treatment for enterovaginal fistula with Kampo medicine.<br>A 62 year-old female who had ileoanal canal anastomosis for ulcerative colitis developed symptoms of gas release and defecation from the vagina. Although these symptoms had disappeared with conventional medicine previously, they recurred 7 years later. There was no medical indication for surgery because the fistula could not be located by barium enema or endoscopic examination. She, therefore, visited our outpatient clinic 1 and a half years after all conventional management had ended in vain.<br>Her symptoms were slightly improved by the administration of ifutokaogi, a Kampo formula, although they persisted. Three months after switching her prescription to another Kampo formula, goreisan, her symptoms completely disappeared.<br>In recent years, there has been no report on goreisan for the successful treatment of enterovaginal fistulae. Our case suggests that Kampo medicine can be an option for the treatment of enterovaginal fistula refractory to conventional treatments.
ABSTRACT
Vogt-Koyanagi-Harada (VKH) disease is the second most common uveitis in Japan. This is considered an autoimmune disease as the immune system attacks self-melanocytes, and it is characterized by neurological, auditory, and dermatological symptoms in addition to panuveitis. Standard treatment is systemic steroid mass therapy. Also, an inadequate amount of corticosteroid can cause the disease recur or become protracted.<br>Here, we report a case of new-onset VKH disease successfully treated with a combination of ryutanshakanto prepared at Ikkando and goreisan, without any corticosteroids, in a hepatitis B virus carrier.<br>The patient was a 40-year-old male. He visited an eye clinic with bilateral blurred vision, and was diagnosed with bilateral maculopathy at this clinic. He was then referred to our hospital. We diagnosed him with VKH disease and, in accordance with (traditional Japanese) Kampo medicine, also with dampness-heat (shitsunetsu) of the foot's liver meridian with reverting yin (<i>ashi-ketchin-kankei</i>), mild water retention (<i>suitai</i>) and blood stasis (<i>oketsu</i>). We then administered the ryutanshakanto prepared at Ikkando, plus goreisan. His visual acuity consequentially began to improve gradually from the next day, and the disease was finally cured without the administration of any corticosteroid. Thus we believe this suggests that Kampo therapy for VKH disease can be a viable alternative.
ABSTRACT
Diarrhea frequently occurs after abdominal and pelvic irradiation. In severe cases, patients complain of wa tery diarrhea that can occur more than ten times a day. Stegnotic treatment is usually not effective. We con sider radiation-induced diarrhea as a <i>sessha </i>due to water poisoning (an illnesses caused by excessive water ac cumulation within the body). And we treated radiation-induced diarrhea with a Kampo medicine (goreisan).<BR>Between January 2008 and December 2010, 28 patients with prostatic cancer were treated with radical ex ternal beam radiotherapy in our division. Of 20 patients in a high-risk group, who received prophylactic whole-pelvic irradiation, 18 patients (83.3%) had diarrhea. Of 8 patients in an intermediate-risk group, who received small doses of pelvic irradiation, 5 patients (62.5%) had diarrhea. Of 2 patients in a low-risk group, who did not receive prophylactic pelvic irradiation, none had diarrhea. Goreisan efficacy was evaluated in these 20 cases. In 18 patients (90%), diarrhea was treated successfully with normal-dose goreisan extracts. In the remaining 2 cases (10%), double-dose goreisan extracts were used with effective results. Thus goreisan provided control of diarrhea for acute radiation colitis.
ABSTRACT
We report a case of chronic heart failure with hypotension, successfully treated with goreisan (<i>Wu lin san</i>).In this case, goreisan improved both the heart failure symptoms and water regulation. This 91-old woman had been receiving treatment for congestive heart failure, mitral regurgitation, aortic regurgitation and atrial fibril lation, and had undergone pacemaker implantation due to sick sinus syndrome. She underwent repeated hospi talization due to aggravation of her chronic heart failure. She was re-admitted because of systemic edema as well as exacerbation of heart failure symptoms which included pleural effusions. Blood pressure remained constant at about 80/50 mmHg. She was prescribed furosemide 40 mg. Thereafter, cerebral infarction compli cations arose. Therefore, it became difficult to increase the quantity of diuretics. We administered goreisan without change to the other oral medications. Many of her symptoms improved and the pleural effusion resolved without affecting blood pressure.<br>Goreisan is one representative herbal formula for promoting diuresis. In this case, it is thought that goreisan showed actions that influenced water regulation.
ABSTRACT
Goreisan, a well-known hydrostasis modulating formula, has been traditionally used against edema, thirst, spontaneous sweating, and oliguria. Patients undergoing maintenance hemodialysis (HD) have a condition of chronic water metabolism abnormality. Acute changes in water metabolism due to HD therapy frequently cause disdialysis syndrome (including muscle cramps), therefore, the prevention and treatment of disdialysis syndrome is of importance. In this study, 20 patients with history of disdialysis syndrome undergoing HD were administered goreisan (5.0 g/day) and its effect was investigated. After 8 weeks of goreisan therapy, diagnostic <i>suitai </i>syndrome criteria (pre-treatment 40.9 ± 8.7, post-treatment 33.2 ± 7.8 points), total 10% NaCl dosages (20 mL/syringe) to treat muscle cramps during HD (pre 2.9 ± 0.6, post 1.9 ± 0.6 syringes/week), serum brain natriuretic peptide (BNP) concentrations after HD (pre 165.4 ± 48.3, post 148.4 ± 39.0 pg/mL), and systolic blood pressures (pre 90.8 ± 15.0, post 100.1 ± 13.5 mmHg) indicted statistical improvement (p < 0.01).These effects were observed not only in patients with no diabetes mellitus (DM), but also in patients with DM.These results indicate the possibility that goreisan is effective for prevention of disdialysis syndrome and muscle cramps in patients under HD.
ABSTRACT
We report a case of refractory pleural effusion after mitral valve replacement (MVR) successfully treated by adding goreisan. A 60-year-old man had right pleural effusion with exertional dyspnea in spite of taking two diuretics (furosemide 60 mg and spironolactone 25 mg a day) for 2 years after MVR. He underwent drainage twice and spironolactone was increased to 50 mg, but his pleural effusion volume still increased. Then in addition, he received goreisan 7.5 g a day, and the pleural effusion was decreased and stabilized. This suggests that goreisan is a candidate drug for additional treatment, when pleural effusion is uncontrolled because of heart failure, despite taking diuretics.
ABSTRACT
We report a patient who was successfully treated with a herbal formulation of goreisan (Wu-ling-san) for recurrent vomiting associated with pyloric stenosis, with significant simultaneous improvement of congestive heart failure.<br>A 78-year-old woman was in a bedridden state after cerebral infarction and was being fed through a nasal tube. She often experience repeated vomiting and aspiration pneumonia. Cicatricial stenosis was found in the pyloric region and we performed an expansion operation with balloon endoscopy. However, symptoms did not improve and her heart failure worsened. Therefore, we administered goreisan. Urinary output volume increased, edematous changes gradually disappeared, and pleural effusion decreased. The stenosis-related lesion did not change, but the vomiting ceased, even after nasal tube feeding was resumed.<br>Goreisan is an herbal formula used to promote diuresis that is considered to correct water absorption in digestive organs. In this case, goreisan was effective for the improvement of many symptoms.
ABSTRACT
Hansen's disease (HD) is a chronic infectious disease caused by the Mycobacterium leprae, which parasitizes skin macrophages and Schwann cells of peripheral nerves. Left untreated, leprosy can be progressive, causing permanent damage to the skin, nerves, limbs and eyes due to sensory disturbance and neuritis. Many HD patients suffer from refractory neuralgia for which neither painkillers nor other western medicine are usually effective. Here, we will report the case of an 85 year-old male, whose refractory neuralgia remarkably improved with goreisan. The mechanisms by which goreisan was effective may be as follows : (1) neuralgia pathology is an interstitial edema of peripheral nerves, and can explain as a local <i>Sui-doku</i>, a specific <i>Sho</i> for goreisan ; (2) peripheral nerve ischemia, caused by scar formation from chronic inflammation, leads to dysfunction of Na<sup>+</sup>/K<sup>+</sup> ATPase, and extracellular potassium concentration increases. This environmental change leads a neural hypersensitivity, and goreisan is known to decrease extracellular potassium concentrations. This case suggests goreisan might be worth considering for use in refractory neuralgia, not only in HD patients, but also in other neuropathies.
ABSTRACT
Teian Azai classically described that summer heat was caused by humidity in addition to hot weather. It may occur after becoming chilled while asleep, enjoying the evening cool, and taking cold foods and drinks. Humidity and high temperature prevent <i>qi</i> circulation in the stomach. Therefore, he insisted that goreisan, a formula improving water circulation, could be applied for diverse symptoms caused by summer heat. We present two cases of patients with epigastralgia caused by cold foods and drinks in air-conditioned environments, whose symptoms were improved by goreisan. In prior treatment, anchusan in case1, and rikkunshito in case 2 were not effective for their epigastralgia. Nineteen cases of epigastralgia after taking cold foods and drinks in summer, including these two cases, revealed that goreisan was efficacious against summer epigastralgia with white fur on the tongue and a stuck feeling in the pit of the stomach. Abdominal fluid congestion is a major abdominal sign for an indication of goreisan, but a stuck feeling in the pit of the stomach presented in some effective cases with goreisan. We concluded that epigastralgia caused by cold foods and drinks with white fur on the tongue and a stuck feeling in the pit of the stomach could be a target for the application for goreisan.
ABSTRACT
Hansen's disease (HD) is a chronic infectious disease caused by the Mycobacterium leprae, which parasitizes skin macrophages and Schwann cells of peripheral nerves. Left untreated, leprosy can be progressive, causing permanent damage to the skin, nerves, limbs and eyes due to sensory disturbance and neuritis. Many HD patients suffer from refractory neuralgia for which neither painkillers nor other western medicine are usually effective. Here, we will report the case of an 85 year-old male, whose refractory neuralgia remarkably improved with goreisan. The mechanisms by which goreisan was effective may be as follows : (1) neuralgia pathology is an interstitial edema of peripheral nerves, and can explain as a local <I>Sui-doku</I>, a specific <I>Sho</I> for goreisan ; (2) peripheral nerve ischemia, caused by scar formation from chronic inflammation, leads to dysfunction of Na<SUP>+</SUP>/K<SUP>+</SUP> ATPase, and extracellular potassium concentration increases. This environmental change leads a neural hypersensitivity, and goreisan is known to decrease extracellular potassium concentrations. This case suggests goreisan might be worth considering for use in refractory neuralgia, not only in HD patients, but also in other neuropathies.